title: GC-MS analysis of breath odor compounds in liver patients.
abstract: BACKGROUND
  Liver diseases can cause a sweet, musty aroma of the breath, called fetor hepaticus. Even in a stage of cirrhosis, the disease can be asymptomatic for many years. Breath analysis might be helpful to detect occult liver pathology.
  
  
  OBJECTIVE
  This study examined whether specific breath odor compounds can be found in liver patients, suffering from cirrhosis, which might be useful for diagnosis.
  
  
  METHODS
  Fifty-two liver patients and 50 healthy volunteers were enrolled. Alveolar air was analyzed by gas chromatography-mass spectrometry. Using discriminant analysis a model for liver disease was built.
  
  
  RESULTS
  Dimethyl sulfide, acetone, 2-butanone and 2-pentanone were increased in breath of liver patients, while indole and dimethyl selenide were decreased. Sensitivity and specificity of the model were respectively 100% and 70%.
  
  
  CONCLUSIONS
  Fetor hepaticus is caused by dimethyl sulfide and to a lower extent by ketones in alveolar air. Breath analysis by GC-MS makes it possible to discriminate patients with breath malodor related to hepatic pathologies.
authors.affiliation: Department of Periodontology, Faculty of Medicine, Catholic University of Leuven, Kapucijnenvoer 33, BE-3000 Leuven, Belgium.
authors.forename: Sandra
authors.initials: S
authors.lastname: Van den Velde
authors.forename: Frederik
authors.initials: F
authors.lastname: Nevens
authors.forename: Paul
authors.initials: P
authors.lastname: Van Hee
authors.forename: Daniel
authors.initials: D
authors.lastname: van Steenberghe
authors.forename: Marc
authors.initials: M
authors.lastname: Quirynen
mesh_terms: D000328:Adult; D001944:Breath Tests / Q000379:methods*; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000378:metabolism; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods*; D006209:Halitosis / Q000378:metabolism*; D006801:Humans; D007211:Indoles / Q000032:analysis; D007659:Ketones / Q000032:analysis; D008103:Liver Cirrhosis / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D016566:Organoselenium Compounds / Q000032:analysis; D051437:Renal Insufficiency / Q000378:metabolism; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013440:Sulfides / Q000032:analysis; D055549:Volatile Organic Compounds / Q000032:analysis*
chemical_list: D007211:Indoles; D007659:Ketones; D016566:Organoselenium Compounds; D013440:Sulfides; D055549:Volatile Organic Compounds; C030374:indole; C004784:dimethyl sulfide; C013503:dimethylselenide